Placental vessel thrombosis as a cause of antenatal fetal death in pregnant women with novel coronavirus infection
Background: Adverse perinatal outcomes in patients with novel coronavirus infection (COVID-19) have been described in isolated cases. The ongoing effect of the virus on the body necessitates the accumulation of information on the causes of complications during the gestation period, especially in mild and moderate disease forms that do not lead to severe respiratory and multiple organ failure, which is important for managing pregnancy and developing measures to prevent adverse perinatal outcomes in patients with COVID-19.Malgina G.B., Grishkina A.A., Dyakova M.M., Bychkova S.V., Chistyakova G.N., Pepelyaeva N.A., Melkozerova O.A., Bashmakova N.V., Pestryaeva L.A.
Case report: The paper describes 2 cases of antenatal fetal death in pregnant patients with mild and moderate COVID-19 and a familial history of non-developing pregnancies that occurred in the third wave of the epidemic process. One patient was recorded to have antenatal fetal death that occurred at 37–38 weeks’ gestation with a birth weight of 2670 g and the other patient had that at 23–24 weeks’ gestation with a birth weight of 520 g in the late stages of the disease (days 9 and 13, respectively). These patients are described to have placental morphological alterations; there was a preponderance of the signs of severe maternal vascular malperfusion as thrombosis in the intervillous space with massive fibrin deposits; large hematomas and infarcts, extensive numerous areas of fibrinoid villous agglutination and an inflammatory reaction. At the same time, the standard methods were used to detect viral RNA in the tissues of the placenta, fetal lungs, and maternal nasopharynx.
Conclusion: The analysis of each antenatal fetal death case in pregnant patients with COVID-19 is the basis for the formation of recommendations for the prevention of perinatal complications.
Keywords
novel coronavirus infection
pregnancy
antenatal fetal death
placental vessel thrombosis
maternal vascular malperfusion
References
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Received 11.02.2022
Accepted 06.05.2022
About the Authors
Galina B. Malgina, Dr. Med. Sci., Associate Professor, Director of the Ural Research Institute of Maternity and Child Care, Ministry of Health of Russia, galinamalgina@mail.ru, https://orcid.org/0000-0002-5500-6296, 620028, Russia, Ekaterinburg, Repin str., 1.Anastasia A. Grishkina, PhD, Pathologist, Department of Immunology, Clinical Microbiology, Pathomorphology and Cytodiagnosis, Ural Research Institute of Maternity and Child Care, Ministry of Health of Russia, xumukyc.ru@mail.ru, https://orcid.org/0000-0001-7433-2217, 620028, Russia, Ekaterinburg, Repin str., 1.
Maria M. Dyakova, Junior Researcher, PhD student, Ural Research Institute of Maternity and Child Care, Ministry of Health of Russia, mariadakova40@mail.ru,
https://orcid.org/0000-0001-7911-6783,620028, Russia, Ekaterinburg, Repin str., 1.
Svetlana V. Bychkova, PhD, Leading Researcher, Ural Research Institute of Maternity and Child Care, Ministry of Health of Russia, +7(343)37-155-20,
simomm@mail.ru, https://orcid.org/0000-0002-8892-7785, 620028, Russia, Ekaterinburg, Repin str., 1.
Guzel N. Chistyakova, Dr. Med. Sci., Professor, Head of the Department of Immunology, Clinical Microbiology, Pathomorphology and Cytodiagnosis, Ural Research Institute
of Maternity and Child Care, Ministry of Health of Russia, 7@niiomm.ru, https://orcid.org/0000-0002-0852-6766, 620028, Russia, Ekaterinburg, Repin str., 1.
Natalia A. Pepelyaeva, PhD, Head of the Department, Ural Research Institute of Maternity and Child Care, Ministry of Health of Russia, pepelyaevana@niiomm.ru,
https://orcid.org/0000-0003-3278-2249, 620028, Russia, Ekaterinburg, Repin str., 1.
Oksana A. Melkozerova, Dr. Med. Sci., Deputy Director for Science, Ural Research Institute of Maternity and Child Care, Ministry of Health of Russia,
abolmed@mail.ru, https://orcid.org/0000-0002-4090-0578, 620028, Russia, Ekaterinburg, Repin str., 1.
Nadezhda V. Bashmakova, Dr. Med. Sci., Professor, Chief Researcher, Ural Research Institute of Maternity and Child Care, Ministry of Health of Russia,
bashmakovanv@niiomm.ru, https://orcid.org/0000-0001-5746-316X, 620028, Russia, Ekaterinburg, Repin str., 1.
Lyudmila A. Pestryaeva, PhD (Bio), Head of the Department of Biochemical Research Methods, Ural Research Institute of Maternity and Child Care,
Ministry of Health of Russia, pestryaeval@yandex.ru, https://orcid.org/0000-0003-3278-2249, 620028, Russia, Ekaterinburg, Repin str., 1.
Corresponding authors: Maria M. Dyakova, mariadakova40@gmail.com; Svetlana V. Bychkova, simomm@mail.ru
Authors' contributions: Malgina G.B. – the concept and design of the investigation, writing the text, editing; Grishkina A.A. – material collection and processing, writing the text, editing; Dyakova M.M., Bychkova S.V., Pepelyaeva N.A. – material collection and processing, writing the text; Chistyakova G.N. – the concept and design of the investigation; editing; Melkozerova O.A., Bashmakova N.V. – editing the manuscript; Pestryaeva L.A. – material collection and processing.
Conflicts of interest: The authors declare that there are no possible conflicts of interest.
Funding: The investigation has not been sponsored.
Ethical Approval: The investigation has been approved by the Ethics Committee, Ural Research Institute of Maternity and Child Care (Ref. No. 12 dated September 21, 2021).
Patient Consent for Publication: The examinees have been informed about the forthcoming examinations during treatment. Voluntary written consent forms have been issued for processing their personal data, medical interventions, and researches.
For citation: Malgina G.B., Grishkina A.A., Dyakova M.M., Bychkova S.V., Chistyakova G.N., Pepelyaeva N.A., Melkozerova O.A., Bashmakova N.V., Pestryaeva L.A. Placental vessel thrombosis as a cause of antenatal fetal death in pregnant women with novel coronavirus infection.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2022; 5: 162-170 (in Russian)
https://dx.doi.org/10.18565/aig.2022.5.162-170
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